Physiotherapy
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Item Expectations of Individuals with Neurological Conditions from Rehabilitation: A Mixed-Method Study of Needs(South African Society of Physiotherapy, 2021) Olaleye, O. A.; Zaki, D. A.; Hamzat, T. K.Background: Knowledge of the specific expectations of patients with neurological conditions (NCs) from rehabilitation helps in setting attainable goals. Such expectations may vary from situation to situation. There are no studies investigating rehabilitation expectations amongst individuals with NCs in Nigeria. Objectives: The aim of our study was to explore the rehabilitation expectations of individuals with NCs. Method: This convergent mixed-methods study comprised a cross-sectional survey of 105 individuals with NCs and two sessions of Focus Group Discussions (FGDS) amongst eight individuals with NCs. The modified Needs Assessment Questionnaire was used to assess rehabilitation needs as a proxy for rehabilitation expectations, whilst disability was assessed using the World Health Organization Disability Assessment Schedule 2.0. Quantitative data were summarised using descriptive statistics and analysed using inferential statistics at p < 0.05. Thematic analysis was conducted on the qualitative data. Results: Sixty-one (58.1%) stroke survivors, 33 (31.4%) individuals with spinal cord injury (SCI) and 11 (10.5%) with traumatic brain injury (TBI) aged 46.48 ± 15.91 were surveyed. The need for social/recreational activity was the most expressed need (100%) amongst the participants. Mobility was reported as an important need constituting a barrier to enjoying life by 93 (88.6%) participants. Individuals with SCI expressed the greatest needs compared with the other two groups. Needs were significantly correlated with severity of disability (p < 0.05). Four overarching themes (physical health, financial, healthcare services/rehabilitation and emotional/social) representing major areas of needs emerged from the FGD data. Conclusion: Individuals with NCs in Nigeria have specified expectations of rehabilitation. Disability was a major driver of these expectations, irrespective of NC subtype. Clinical implications: Rehabilitation programmes for individuals with NCs should target expressed needs or expectations of each patient cohort and minimise disabilities associated with these conditions.Item Comparison of Community Reintegration and Selected Stroke Specific Characteristics in Nigerian Male and Female Stroke Survivors(Department of Physiotherapy, College of Medicine University of Ibadan, Nigeria, 2014) Hamzat, T. K.; Ekechukwu, N. E.; Olaleye, O.A.This study investigated the difference between community reintegration of male and female stroke survivors and the association between gender of stroke survivors and some selected stroke specific characteristics (type, side of paresis and occurrence) Fifty-two patients (25 males and 27 females) recruited from hospitals in Nigeria took part in the study. Community reintegration (CR) was assessed three months post-admission discharge using the Reintegration to Normal Living Index (RNLI). Demographic and stroke-specific characteristics were obtained using a data form. Data were analysed using descriptive statistics, the Mann-Whitney U test and the chi-square test. Level of significance was set at p = 0.05. The mean age of the participants was 61.21 ± 11.25 years (range 31 – 86 years). There was no significant difference (p = 0.173) between the community reintegration scores of male and female participants. There was also no significant association between gender and each of the selected stroke specific characteristics such as type of stroke (p = 0.279); side of paresis (p = 0.250) and occurrence of stroke (p = 0.670). Community reintegration scores of male and female stroke survivors are not significantly different. There is no significant association between gender and each of the selected stroke specific characteristics.Item Functional Ability, Community Reintegration and Participation Restriction among Community-Dwelling Female Stroke Survivors in Ibadan(Jimma University (Research and Publications Office), 2014) Hamzat, T. K.; Olaleye, O. A.; Akinwumi, O. B."BACKGROUND: Stroke is not gender-discriminatory. Yet, the subject of stroke among females has apparently not received significant attention from clinical researchers. The consequences of stroke include functional and psychosocial sequelae which may cause disability, hinder community reintegration and restrict participation. The inter-relationships among functional ability, community reintegration and participation restriction of community-dwelling, female stroke survivors in Ibadan were assessed in this descriptive study. METHODS: Fifty-two community-dwelling female stroke survivors (mean age = 56.55±9.91 years) were surveyed using consecutive sampling technique. Their functional ability level was measured using the Functional Independence Measure (FIM) while London Handicap Scale (LHS) was used to assess their participation restriction. Data were analyzed using Spearman Rank Correlation Coefficient (rho) and Mann-Whitney U test at p = 0.05. RESULTS: Significantly positive correlations (p< 0.05) were found between functional ability and community reintegration (r = 0.54; p = 0.01) as well as between participation restriction and community reintegration (r = 0.34; p = 0.05). Individuals with left hemiplegia had significantly higher mean rank scores in functional ability (30.41) than those who had right hemiplegia (mean rank scores = 21.94). CONCLUSION: Functional ability which appears to be related to stroke laterality showed positive association with both community reintegration and participation restriction. This suggests that improving the functional ability of the stroke survivors may reduce participation restriction and enhance their reintegration into the community. A similar study which compares male and female stroke survivors in the same community is thus necessary. "Item Development and Evaluation of a Primary HealthCare-based Physiotherapy Intervention and its Effects on Selected Indices of Stroke Recovery(MA Healthcare Ltd, 2013) Olaleye, O. A.; Hamzat, T. K.; Owolabi, M. O.Aim: To develop a Primary Healthcare-Based Physiotherapy Intervention (PHCPI) that requires simple, inexpensive, easy-to-use equipment for stroke rehabilitation and evaluate its effects on selected clinical indices of recovery among post-acute stroke survivors over a 10-week period. Methods: Three databases (Medline, Pubmed and PEDro) were used to identify treatment approaches with proven efficacy. The authors synthesised these treatment approaches to develop the PHCPI, which was used in a repeated measure design involving 25 (mean age=60.6 ± 10.2 years) consenting individuals with first-incidence stroke. These individuals were treated at a primary health centre, twice weekly for 10 consecutive weeks. Outcomes were assessed using the Modified Motor Assessment Scale (MMAS), the Short Form Postural Assessment Scale for Stroke (SF-PASS) and the Reintegration to Normal Living Index (RNLI), before the intervention and fortnightly thereafter. Walking speed and quality of life were also assessed before the intervention and at week 10 of it. Results: Within-subject multivariate analysis, after controlling for gender, showed a significant increase in motor function, postural balance, walking speed and quality of life. Their community reintegration scores also improved over the period. Conclusion: The PHCPI resulted in improved motor function, community reintegration, walking speed, postural balance and quality of life among community-dwelling stroke survivors. This intervention can be used for stroke rehabilitation at primary health centres.Item Standing asymmetry and functional ability in relation to gait parameters in hemiparetic stroke patients(Joint Centre for Research in Prosthetics & Orthotics and Rehabilitation Programmes, 2006) Hamzat, T. K.; Olaleye, O. A.; Adeniyi, A. F.; Awolola, E. O.Objective: Relationships between some temporospatial gait parameters and each of functional ability and standing asymmetry (measured as asymmetry ratio) in hemiparetic stroke patients were investigated. Design: Ex-post facto research design. Sample Size: Thirty-one (18 males and 13 females) patients with hemiparesis, aged between 35 and 65 years (56.97 ± 11.53) were consecutively recruited from the physiotherapy out-patient facility of a Nigerian teaching hospital. Measurements: Two weighing scales were used to measure relative standing weight distribution on each lower limb and subsequently converted to asymmetry ratio (AR), while functional ability was determined using the modified motor assessment scale. Gait parameters were assessed using foot print analysis, obtained during a 10-metre walk test. Pearson's correlation matrix (r) was calculated to establish relationship at 0.05 alpha. Results: Results showed a significantly negative correlation between asymmetry ratio and each of stride length, step length and functional ability (p<0.05). Significantly positive correlation was found between motor function and cach of stride length, step length, cadence, walking speed and step time (p<0.05) were obtained. Conclusion: The lesser the standing asymmetry in stroke patients, the better their motor functions and gait performance. Programmes aimed at enhancing weight bearing activities through the paretic lower limb, to attain standing symmetry, may be used to enhance functional ability and produce better gait functions in post-stroke patients.Item Stroke Rehabilitation: When Should Ambulation Activities Commence?(Medical Rehabilitation Therapists (Registration) Board of Nigeria, 2002) Olaleye, O. A.; Hamzat, T. K.Stroke is an important cause of disability worldwide. It results in considerable impairments such as sensory, motor, mental, perceptual and language functions. The motor deficits are characterized by hemiplegia and attendant physical limitation. Independent walking function is a highly desired goal among stroke survivors. It is therefore not surprising that recovery from the illness is often measured using ambulation as yardstick by both the patients and their relatives. This strong desire for ambulation often leads to pressure on the attending physiotherapist to commence ambulation promptly. However, some factors need to be taken into consideration by the physiotherapists before commencing ambulation in stroke rehabilitation. This article looks into issues that should be addressed before training ambulation in stroke patients undergoing rehabilitation.Item Perceived Barriers and Facilitators of Return to Driving Among a Sample of Nigerian Stroke Survivors – A Qualitative Study(Springer International Publishing, 2021) Nwankwo, K. O.; Olaleye, O. A.; Hamzat, T. K.; Ekechukwu, E. N. D.Stroke affects driving ability and as such impedes mobility, independence, freedom and quality of life. Return to driving after stroke serves as an integral part for community reintegration and improved quality of life. Driving is considered critical for continued independence, employment and recreation among stroke survivors. There was therefore the need to better understand the perceived facilitators and barriers to driving among stroke survivors with pre-stroke driving history. This study seeks to better understand the perceived facilitators of and barriers to return to driving after stroke so as to enable proper outcome in patient management and policy formulation. This is a qualitative phenomenological app roach using in-depth focus group discussion (FGD) was employed. Six stroke survivors (5 males; 1 female) aged 58.0 ± 7.9 years participated in the FGD. Half (50%) of the participants had returned to driving. Seven themes were generated for the barriers as well as facilitators of return to driving after stroke. Findings from this study suggests that majority of the facilitators of return to driving are intrinsic factors. Majority of stroke survivors wish that they could be able to stop being dependent on their caregivers for their activities of daily living (ADL) which could invariably lead to activity limitation and participation restriction. Attention should be paid on the pre-morbid driving status of stroke survivors so as to enhance the facilitators of return to driving and minimize the barriers to return to driving after stroke.